Sunday, June 4, 2017

A Little Bit of This and A Little Bit of That


A Little Bit of This and A Little Bit of That

I just got finished in the kitchen, doing my meal prep for the week.  I take 2-3 hours on Sunday morning and devote to cutting vegetables for the week, making sauces to expedite cooking time during the week, and even a little baking.  Today’s bread was an epic fail.  I followed the instructions to a tee – the only thing I can think of is something with the humidity in the air affected how it turned out.  The bread did rise as it said it would in the book.  I took a peek while it was baking and it was completely sunken in.  So not really sure, but I’m blaming it on the weather.  Yesterday it rained off and on ALL day.  Today it is cloudy and humid as all get out and there are supposed to be showers again.  So, I’m not going to get mad about it, I’m just going to have to keep trying.  Each week (time permitting) I’m trying a new recipe from Bread Illustrated ).  This is what I’m using as my stress relief/downtime which normally ends up yielding good results.  As I said, not gonna get mad, just gotta forget about it and try a new recipe (not sure I’ll repeat this one since it was such an epic fail…maybe in the future).
These were not the epic fail - these were Butter Fan Rolls from last week.  Luckily bread freezes!
Last week I had an 11-year old patient recently diagnosed with Type 2 diabetes (DM).  I’ll repeat that again so it can sink in what I just said.  11-year old patient diagnosed with Type 2 DM.  For anyone that doesn’t think we have a problem on our hands, this one patient alone should demonstrate we have a problem.  11 years old, 225 pounds, and knows nothing other than junk food and soda.  Houston we have a problem, a HUGE problem (no pun intended). This is one of many – there are others out there.  Whether they are about to be diagnosed or are walking around without knowing they have it, they’re about to have a rude awakening.  We have to start making healthy changes and start them when they are young.   Many people don’t act on changes to their diet until they are forced to do so – there’s never really been a push for prevention.  The irony is that most of the chronic diseases that we are seeing surface can be prevented through diet and exercise.  Diabetes is one of those said diseases.  While there are genetic risk factors associated with Type 2 DM, there are many studies that prove by making changes in diet and exercise it will help offset some of the risk.  Here are two articles I just recently was reading that talked about “reversing DM”.  And I should make mention that one does not “reverse DM” rather one controls their DM.  Once DM surfaces, it is there to stay.  Our aim is to control DM (and it can be), but it doesn’t just “reverse” as is common language used and leads people astray in thinking it will “disappear”.
A1c - the average blood sugar over 3 months - here shows a diagnosis of diabetes with a 6.6%.  After diet and exercise intervention, the patient's A1c decreased to 6.2%, a level showing control and now prediabetes.

A recent study suggested to have carbohydrate-rich meals earlier in the day.  They compared men with prediabetes having the carb-rich meals early (by 1:30 pm) and then a high-fat meal later on versus men having a fat-rich meal early and then the carb-rich meal later on.  What they found?  Glucose tolerance,  the body’s ability to handle carbs, gets worse as the day progresses.                                                                                                                                                           Sci. Re.. 2017 doi:10.1038/srep44170

In general I tell my patients to aim to reduce the load of carbs at meals – I don’t believe people at times have any idea of how many carbs they are consuming at any one meal.  A bowl of Raisin Bran (a bowl, not just a cup, what people are actually eating) could average around 135g of carbs.  A male should have only 45-60g of carbs/meal, so yes, I’m looking at you Raisin Bran – thought to be healthy when in fact it’s not!  We need to raise carb awareness in people and in general aim to reduce the load throughout the day (and not just at night) in people with prediabetes.  Both the quality and the quantity of the carbs matter when it comes to eating healthy.
In case you didn't believe Raisin Bran had that many carbs in what would be a bowl (some people might even be eating more!)
The other study looked at strength training.  The trial was called the Resist Diabetes trial.  They provided strength training for three months, twice a week, 12 supervised exercises for 8-12 repetitions each. They were followed up with 6 months of encouragement, followed by six months on their own.  After the 15 months, 30% of the participants had levels indicating their blood sugar levels were in control (or as the article states, “they no longer had prediabetes”)                             PLoS ONE 2017 doi:10.1371/journal/pone.0172610e

The bottom line?  If you’re not doing strength training, get started NOW.  People lose muscle as they age.  Building muscle helps insulin become more sensitized, meaning it works more efficiently.  And building muscle helps glucose uptake, so not as much insulin is even needed to begin with.  Strength training is a win-win all around.  Get started now.

Here are other key tips I tell all my patients – you choose what you need to work on – but consistency is also important:

-Lose weight (or not gain) extra pounds.  This is the obvious one and doctors tell their patients this, but the truth is through changes with diet and exercise and less focusing on the number on the scale, they will begin to lose weight.

-Shoot for at least 30 minutes of brisk walking or other aerobic exercise.  This sitting all day thing, it’s killing us.  Get up and move!

-Limit white flour, potatoes, and sweets – aim for whole grains and keep desserts to actual celebrations (not every day!)

-Eliminate any and ALL sugary beverages.  Unless you are an athlete and actually need that sports recovery drink, NO sweetened beverages.  Start thinking about your morning cup of joe – NO added sugar, period.

-Increase your non-starchy vegetables – broccoli, green leafy vegetables, peppers, onions, carrots, etc – we do NOT eat enough of this and we need to do better.  The FIBER plays a critical role in our body.  Everyone might know fiber helps them go to the bathroom, but it also helps lower blood sugar levels, lower blood pressure, lower cholesterol, and more recently been shown to help people lose weight.  Fiber – get it from whole foods.

Remember, the good news is that you can reduce your risk of diabetes.  Make changes in your diet and exercise, today! 

My cookbook obsession continues.  I mean did we expect anything less?  My latest acquisition is - Salt, Fat, Acid, Heat.  I’m excited to delve further into this book as each one of these elements plays an essential role in cooking.  I read the book by Michael Pollan, Cooked, a few years back and feel I need to learn more.  If I could master just these four elements —Salt, which enhances flavor; Fat, which delivers flavor and generates texture; Acid, which balances flavor; and Heat, which ultimately determines the texture of food— anything I cook will be delicious, minus user error, but you know what I mean.  I’ll at least have the theory.  And then comes the practice, because practice makes perfect.  Now to decide which section I’ll start with first…

I’m always looking for inspirational quotes and pictures to post for my Wellness Wednesday on the internet.  There are a lot that depending on the situation I’m going through will speak to me.  I saw a shirt a person was wearing the other day that said, “Calm to Crazy”.  I immediately thought of yoga and that by practicing yoga it helps me go from crazy to calm, so maybe we should make a shirt for that instead?!
Yoga has always been something that helps me get literally grounded and brings me back to my breath.  I feel if I can control my breath than I can control what’s going on around me (or at least accept what will be).  Lately I’ve felt that my breath is unsteady, and at times short and shallow – and while this may be due to certain circumstances lately, it’s my gentle reminder to stay true to my yoga and simply practice, aiming for consistency.  There are going to be bumpy roads and there are going to be moments in life that seem as if they are too much to handle.  The truth?  More reason to practice and tap into my breath control – plug in and make sure I am in balance and aligned so that I am able to go with the flow.  The more I’m able to control my breath, the more I’m able to control what’s going on around me.  Practice and all is coming.


Last but not least, my latest obsession, aka, what food I’m eating on repeat.  It depends on the day and the timing of my meals, but I’ll eat this ricotta cheese and tomato together as a snack as is (with lots of herbs mixed in for added flavor, although it tastes just fine without).  If my day is tending towards a long day with dinner later at night, I will have the same snack, only this time with crackers included – so think carbs, protein, and some healthy fat – all in order to sustain me until I do get home for dinner.  Simple and delish.  Eating healthy doesn’t have to be complicated.  Until next time…